Examination table

ABSTRACT

An examination table which can be used for handicapped or injured patients can be lowered enough to permit sliding a wheelchair bound patient directly onto the table without having to lift the patient. The head of the table can be raised or lowered, and the patient&#39;s head and upper body can be strapped down to the table where appropriate. Side bars keep the patient on the table when there is a danger that the patient may slide or roll off of the table. Two types of stirrups are provided: conventional stirrups can be moved into any direction to accommodate patients whose legs may move or be locked in different directions from the attitude of conventionally attached stirrups. For patients who require additional leg or foot support or who require support distributed over a large area, stirrups fitted with boots can be used to provide this support. The boots are sufficiently long to provide support at least up to the knee, and preferably up part of the thigh. A conveyor belt is provided to move patients from the head of the table down to the foot.

FIELD OF THE INVENTION

The present invention is directed to an examination table which can beused with handicapped or injured patients.

BACKGROUND OF THE INVENTION

Treating the medical needs of handicapped or injured patients requiressomewhat different equipment from that used for conventional patients.For example, if a patient is wheelchair bound, the patient must belifted onto an examination table from the wheelchair. Since the seatlevel of the wheelchair is generally about nineteen inches above theground, and the average examination table can only be lowered to about26 inches, the patient must be lifted out of the wheelchair onto theexamination table. This lifting requires several persons, depending uponthe weight and mobility of the wheelchair bound patient.

In addition to requiring means to move from wheelchair to examinationtable, many handicapped or injured patients have other special needs.For example, where the patient has one leg longer than the other, eitherdue to congenital problems or to amputation, both legs do not conform tothe configuration for conventional stirrups. Particularly in the case ofsingle amputees, it is difficult to situate both legs in stirrups forconventional gynecological examinations.

Even when both legs are approximately the same length, some patientsexperience muscle spasms, which may be aggravated when the patient'sfeet are placed into stirrups. It is thus important to provide means toretain the patient's legs in place comfortably during the time that thepatient is on the examination table. Of particular concern is whendealing with burn patients, whose skin is particularly sensitive to anytype of pressure, yet whose muscles may be subject to spasms whenimmobilized.

Occasionally the patient's muscular spasms are not confined to the legs,so that the entire body must be restrained while the patient is on thetable. Although handrails on either side of the table can be used tomaintain the patient in position on the table, handrails are often notsufficient to keep the patient in a stable position during a medicalexamination or procedure.

Unfortunately, the needs of handicapped and injured patients havetraditionally been ignored, and, to date no medical examination tablesor obstetrical tables have been designed to accommodate patients with avariety of handicaps. None is capable of being adjusted to suit theparticular needs of each patient. Although examination tables having avariety of features are presently available, none of these tables hasbeen designed specifically to aid a physician in examining a handicappedor injured patient and to enable the patient to undergo medicalexaminations or treatment with some degree of comfort.

A number of prior workers have provided examination or obstetricaltables with a variety of features. For example, Murphy, in U.S. Pat. No.1,607,168, discloses an obstetric table having adjustable shoulderstraps and limb holding devices which support the patient's leg from theheel to the knee. However, there is no recognition that the patient'slegs may not be the same length.

Broesel, in U.S. Pat. No. 2,757,058, discloses a delivery crutch forobstetrical tables for supporting the mother's legs during delivery.Although this crutch can be adjusted for a variety of leg sizes, thereis no provision for adjusting the crutch to accommodate legs that may beincapable of being moved into standard positions for delivery.

Comper, in U.S. Pat. No. 2,067,891, discloses leg supporting means forobstetrical beds which are adjustable to accommodate legs of any size.However, there is no provision for accommodating legs which may not becapable of angular movement in the direction needed for obstetricalprocedures.

Wiruth, in U.S. Pat. No. 2,057,992, discloses a leg support andrestraining device which firmly secures the entire leg from just abovethe knee to the foot. The device can be locked against rotation andlongitudinal movement. Straps are provided for securely strapping thepatient's legs, ankles and feet to the supports.

Allen, in U.S. Pat. No. 4,809,687, discloses a stirrup for supporting apatient's limb in a desired attitude. The stirrup includes a shell linedwith a soft material. The shell can be suspended from a support byadjustable straps, and the straps can be adjusted to control thepositioning of the limb. Two boot-like attachments of the stirrup can beused to support a patient's legs for gynecological procedures.Unfortunately, in this case the shell is suspended from the support, sothat there is insufficient support for a limb that may be spastic orunable to remain in one spot for an extended period of time.

A heel supporting boot or bed patients is shown in Schleicher et al.,U.S. Pat. No. 4,186,738.

VELCRO® hook and loop type filamentary engaging fasteners are used toimmobilize patients on tables used for X-ray procedures. Cabansag, inU.S. Pat. No. 3,933,154, discloses an immobilizer for use in X-ray andsurgical procedures which includes a back which can be rigid or bent ina variety of positions. The immobilizer has a plurality of flexiblestraps for securing different sections of a patient's body againstmovement. Means are provided for restraining knees and elbows as well asthe head.

Nishiyama et al., in U.S. Pat. No. 3,861,666, disclose a device forfastening a patient to a bed plate, along with engageable support bands.

Unfortunately, to date no one has recognized the special needs ofpatients with a variety of handicaps or restrictions from injuries, andconsequently there has been no provision for examination tables whichenable a handicapped person to be examined with a minimum of distress tothe patient as well as the requirement for a minimum number of personnelto aid the patient in gaining access to the table.

SUMMARY OF THE INVENTION

It is an object of the present invention to overcome the aforesaiddeficiencies of the prior art.

It is another object of the present invention to provide an examinationtable which can be comfortably used by patients with a variety ofhandicaps or injuries and which enables the patients to readily gainaccess to the table with a minimum of assistance.

It is a further object of the present invention to provide anexamination table which accommodates patients having limbs of varyinglength and flexibility.

It is yet another object of the present invention to provide anexamination table which includes means for restraining patientsexperiencing muscle spasms.

It is still another object of the present invention to provide anexamination table which can be used for patients with skin that issensitive to even slight amounts of pressure.

According to the present invention, an examination table is providedwhich can accommodate patients having a great many different types ofhandicaps, including single or double amputees, patients having musclespasms, patients who are wheelchair bound, burn patients, and the like.Of primary importance is that the table is designed so that it can belowered to approximately nineteen inches above the floor level, so thata person in a wheelchair can merely slide from the seat of thewheelchair onto the table. After the patient has been moved onto thetable, the table then can be raised to the proper height for thephysician or other medical personnel to conduct a medical examination.

The examination table of the present invention can be used for any typeof medical examination of patients, and any required additions to thetable to accommodate different types of physical examinations that maybe contemplated including armboards, alternative types of leg supports,etc.

Limb supports are provided for both legs and arms if desired. The limbsupport means of the present invention provides support over asubstantial portion of the limb, thereby avoiding pressure points andconstriction. In addition, the limb supports permit easy manipulation ofthe attitude of the limb, making it possible to provide the desiredorientation of the limb which is being supported for a variety ofmedical procedures.

Conventional stirrups are provided for patients who are capable ofinserting a foot into a conventional stirrup. These conventionalstirrups, however, can be retracted or otherwise moved out of the waywhen not in use.

For patients who are not comfortable with using conventional stirrups,alternative stirrups are provided. These stirrups comprise a boot-likemember into which the patient inserts a leg. The leg is cradled in aboot comprising a shell which may be lined with a soft cushioningmaterial. The shell is shaped to conform to the underside of the limb tobe supported.

Optional armboards are provided on each side of the table to support oneor both arms during administration of intravenous fluids or applyingtreatment to the arm. Cushioning material may be provided in thearmboards as well.

A number of flexible straps are attached to the examination table atvarious locations. The flexible straps are adapted to be attached overdifferent parts of a patient's body to ensure complete restraint ofbodily parts that must be restrained. Elbow and knee restraints can beprovided with means for drawing the straps tight around each limb whererequired to secure the limb against movement.

The head portion of the table is adjustable to different positions toaccommodate patients of different heights or differing requirements forhead elevation.

In another embodiment, the table is equipped with a conveyor belt whichglides over the top of the table to move a patient from the head of thetable to the foot of the table to facilitate placement of patients' feetinto the stirrups,

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows a side view of the examination table of the presentinvention

FIG. 2 shows a front view of the examination table of the presentinvention.

FIG. 3 shows a boot-like stirrup for use on the examination table.

FIG. 4 shows a side view of the examination table equipped with aconveyor belt.

DETAILED DESCRIPTION OF THE INVENTION

The examination table of the present invention is particularly usefulfor handicapped or injured patients. Although the table illustrated inthe drawings is described as being for gynecological use, the table canbe used for all types of medical examinations, depending upon theindividual needs of the patient and the types of accessories attached tothe table.

Of particular importance is that the table can be lowered to a minimumheight of about nineteen inches, which is sufficiently low to permitsliding a wheelchair bound patient directly from the wheelchair onto thetable, without the necessity of lifting the patient from the wheelchair.For patients who may be spastic or experience rigidity in one or morelimbs, it is particularly useful to avoid the requirement for liftingthe patient. Additionally, for injured patients such as burn patients,the patient can be moved onto the table from the wheelchair with aminimum of contact to the patient thus reducing the pressure applied toinjured skin. Once the patient is placed onto the table, the table canthen be raised to any desired height to accommodate the needs of theexamining physician or other medical personnel.

The table 1 comprises a broad base 4 which is approximately the lengthand width of the top surface of the table. The top of the table, whichsupports the patient, is connected to the base 4 by telescoping pole 3.When the table is raised or lowered, the telescoping pole 3 telescopesup or down as the height of the table is changed.

The top of the table, the patient support, 2 is made of wood or similarrigid material that can bear an adult patient's weight. This top 2 isgenerally covered with a cushion 14 which provides padding for thepatient. This cushion 14 may be covered with a washable, waterproofmaterial for ease in cleaning.

Because the needs of each patient vary, the table is designed to provideaccess and comfort for patients with many different types ofrequirements. Straps 11, which may be fastened with VELCRO® hook andloop type filamentary engaging fasteners, buckles or straps, arepositioned at mid-thigh and mid-chest on top of the table. The number ofstraps provided may vary depending upon the needs of the individualpatient; however, at least two straps as illustrated should be provided.Additional straps are located at the top (head) of the table and nearerthe bottom of the table if needed.

The straps are attached to the table; each strap has a pair of ends withself attachment means on correspondingly mating sides thereof, such thatwhen the ends are brought into overlapping contact with one another,they will adhere to one another. For example, self attachment means cancomprise hook and loop (VELCRO®-type) fasteners. Alternatively, thestraps can include a buckle or tying means.

Alternatively, two wide support bands maybe provided on the table torestrain patients in the trunk area. Two support bands have the endsfixed to respective lengthwise edges of the examination table.Optionally, a preliminary fixing strip having its outer surface providedwith engagement material and being connected at one end to the fixed endof the support band is provided for initially restraining the patient.When the patient is first placed onto the examination table, she issupported by engagement between the engagement material provided on theinner surface of the first support band and the engagement materialprovided on the outer surface of the second support band, whereby thepatient is securely fixed in place.

Two support rails 10, one on each side of the table, can be raised whenneeded. The support rails 10 are generally in the down position, asshown in FIG. 2, when a patient is being moved onto the table.

The support rails 10 are attached to the table with clamping means suchas bolts which are located on both sides of the table 2. These boltssecure clamps 20 with openings into which the rails can fit. Clampingmeans, such as the lock pins 22 illustrated in FIG. 1, hold the supportrails in place. The support rails can be raised or lowered to thedesired height by releasing the clamping means, raising or lowering thesupport rails to the desired height, and reaffixing the clamping meansto retain the support rails in place. Of course, any type of clampingmeans may be used which permits raising and lowering of the supportrails.

The support rails 10 must be made of a material which is sufficientlystrong to restrain a patient in a state of muscle spasms from rollingoff the table, as well as to permit a patient to use armstrength aloneto maneuver the body along the table. In the case of a paraplegicpatient who has no significant limitation of function of the arms, thepatient can grasp the support rails and move up and down the examinationtable at will. Accordingly, these support rails must be strong enough tosupport the stress applied when a patient moves along the table in thismanner. The support rails can be made of any type of material that willwithstand the types of stresses placed thereupon. One type of materialthat can be used for these support rails is steel tubing ofapproximately 2 inches in diameter. One skilled in the art can readilyidentify many different materials which possess the strength requiredfor such rails.

Two types of stirrups are provided on the table, and each type ofstirrup can be retracted and moved sideways to accommodate any type oflower limb configuration. The boots 5, are specifically provided forpatients whose limbs are not of conventional length because ofamputation, congenital reasons, or for patients whose skin may besensitive to pressure, such as from ulcers or burns. The boots 5 aresupported by a rod means such as a rod 7 which is attached to the tabletop 2 beneath the pad 14 for the patient by a clamp 8. This clamp isdesigned to permit rod 7 to be moved in any direction, for example,sideways to accommodate patients whose legs are locked into position, orto provide maximum comfort to a patient whose legs are very short, aswell as to permit the rod to be moved vertically. Lever 6 locks the boot5 into position once the patient's foot or stump has been insertedtherein. The particular type of clamping means used for the rod 7 is notcritical. However, whatever type of clamping means is used it mustenable the support means to be moved up and down, and sideways orthrough a 360° angle so that the patient's legs may be retained in aninfinite number of positions.

The boots are made of a material which is sufficiently strong and rigidto support a limb comfortably, such as molded plastic. For maximumcomfort, the boots are lined with a soft lining such as quilted fabricof cotton or polyester. Alternatively, the boots can be lined withfleece, foamed synthetic or natural rubber or other soft material. Theboot provides support over a substantial portion of the patient's limb,thereby avoiding pressure points and constrictions, and the liningfurther enhances the even spreading of pressure over the entiresupported surface. The boots can be of any length, but the bootspreferably are sufficiently long to cradle the leg up to the knee.Ideally, the boot should provide support for a leg from toe to calf.

In a preferred embodiment of the invention, the boot-like stirrup 30,shown in FIG. 3, comprises a shell made of a rigid material such asmolded plastic in order to support the limb of a patient and todistribute the points of contact with the boot over as large an area aspossible. The shell includes a rest portion to support the bottom of thefoot and a second portion that supports the rear part of the leg. Aremovable liner 32 is made of a soft, foamed material covered with asmooth, waterproof plastic cover which is easily wiped clean. This linerconforms to the inner portion of the boot which supports the patient'sleg and foot. Fastening means, such as a piece of VELCRO® hook and looptype filamentary engaging fastener 33 is attached to the back of theliner, which mates with a mating fastening means, such as acorresponding piece of VELCRO® hook and loop type filamentary engagingfastener 31 on the interior of the boot preferably in the second portionof the boot, to retain the liner in place. For maximum comfort, a topliner 34 is placed onto the top of the patient's foot or leg. Adjustablestraps 35, 36 are provided to secure the boot onto the patient's leg.These straps can be secured around the patient's leg and foot by anysuitable securing means, such as buckles, ties, or VELCRO® hook and looptype filamentary engaging fasteners.

The bottom and top liners or first and second cushioning means areparticularly useful for patients who suffer from muscle spasms, whichcan involuntarily cause the legs to jerk or twist while in the boots.Each cushioning means distributes the pressure from the boot over aslarge an area as possible, and thus prevents the skin from breaking whenthe leg is jerked or twisted against the restraint.

Conventional stirrups 9 can be retracted when the boots 5 are in use.When the conventional stirrups 9 are in use, the boots 5 can beretracted by adjusting lever 6 and moving the boots out of the way.Alternatively, the rod 7 can be hinged to permit moving the boots out ofthe way. Preferably the conventional stirrups are attached to the tablein such fashion that they can be moved both horizontally and vertically.Examples of types of stirrups and means of attachment with can be usedare shown in U.S. Pat. Nos. 548,024; 2,804,363; 3,452,978; and3,944,205, the entire contents of which are hereby incorporated byreference.

An electrical outlet 12 is provided for ease in connecting electricallypowered instruments for use on the patient. This outlet can bepositioned at any location on the table which does not interfere withthe physician's examination of the patient.

A backrest control 13, which may be manually or pneumatically operated,is placed near the head of the table in order to adjust the height andangle of the portion of the table bearing the patient's head and upperback.

A stainless steel pan 15 is provided near or at the foot of the table.

An armboard 23 on either side of the examination table provides supportfor a patient's arm while the patient is receiving intravenous fluid orwhen any treatment is applied to the arm, such as implantingslow-release contraceptives. Straps 25 are provided on the armboard toencircle the patient's arm and retain it in place on the armboard. Thearmboard is connected to the examination table in much the same way asthe boot stirrups. The arm board is supported by a rod which is attachedto the table beneath the pad 14 by a clamp. This clamp permits the rodto be moved sideways to accommodate patients whose arms may be lockedinto position, or to provide maximum comfort to a patient whose arms arevery short. A lever locks the armboard into position once the patient'sarm has been placed on the armboard. Removable first and secondcushioning means similar to those provided for the boot stirrups may beprovided for additional protection for patients' skin. Examples ofarmboards which can be used in the present invention, as well as meansto attach these armboards to the table, are shown in U.S. Pat. Nos.3,289,674; 2,605,152; 3,227,440; and 4,698,837, the entire contents ofwhich are hereby incorporated by reference.

Particularly for use with patients having burned skin, cushionedremovable liners similar to the liners for the boots are provided forthe armboards. Both upper and lower liners may be provided so that thepatient's arm is surrounded by cushioning while positioned in thearmboard.

FIG. 4 shows the examination table 1 equipped with a conveyor belt 41traversing the patient support lengthwise which is used to move arelatively immobile patient from a wheelchair or other conveyance ontothe table and down the table to the proper position for the medicalprocedure to be performed. The patient is placed onto the conveyor beltat the head of the table 44 and the conveyor belt readily moves thepatient lengthwise across the patient support in the direction of thefoot of the table 45. The patient may be moved as far as desired bycontrolling the amount of motion imparted to the conveyor belt, so thatthe patient is properly positioned for medical procedures to beconducted on the patient. Of particular importance is moving the patientfrom the head of the table down so that the patient's feet or lowerlimbs can be inserted into the stirrups or boots.

The conveyor belt is driven by a conventional motor (not shown) and isconnected to the table by pins 43 which are attached to the table sidesby fasteners 42. The pins 43 move the belt over the pins in a motionthat is from the head of the table 44 to the foot of the table 45.

The table of the present invention thus provides ease in moving ahandicapped patient onto the table, as well as many different ways ofensuring the safety and comfort of the patient. The head can be raisedor lowered, and the patient' head and upper body can be strapped down tothe table where appropriate. Strong side bars keep the patient on thetable when there is a danger that the patient may slide or roll off ofthe table, as well as provide support for a patient to move when usingthe arms. Two types of stirrups are provided; conventional stirrups canbe moved into any direction to accommodate patients whose legs may moveor be locked in different directions from the attitude of conventionallyattached stirrups. For patients who require additional leg or footsupport or who require support distributed over a large area, stirrupsfitted with boots can be used to provide this support. The boots aresufficiently long to provide support at least up to the kneed andpreferably up part of the thigh. Armboards provide support and controlfor the arms during treatment.

The foregoing description of the specific embodiments reveal the generalnature of the invention so that others can, by applying currentknowledge, readily modify and/or adapt for various applications suchspecific embodiments without departing from the generic concept, and,therefore, such adaptations and modifications should and are intended tobe comprehended within the meaning and range of equivalents of thedisclosed embodiments. It is to be understood that the phraseology orterminology employed herein is for the purpose of description and not oflimitation.

What is claimed is:
 1. A stirrup for supporting a patient's limbcomprising:a rigid shell comprising a complete unit having a firstportion to support the bottom of the foot and a second portion thatsupports the rear part of the leg; a plurality of adjustable strapsattached to said shell to retain said limb in said shell; a first linerwhich conforms to the inner surface of said shell, and a second linerwhich covers the top of the patient's limb when the limb is in theshell.
 2. The stirrup according to claim 1, wherein fastening means isprovided on the inner surface of said shell and mating means for saidfastening means is provided in the back of said first liner.
 3. Thestirrup according to claim 2 wherein said fastening means and saidmating means comprise interlocking pieces of hook and loop fasteners. 4.An examination table comprising:a base, a telescoping pole attached tothe base, and a patient support on top of said telescoping pole wherebysaid patient support can be moved upwardly or downward; said patientsupport having a head end, a foot end, and two sides; attached near thefoot of said patient support is a first pair of stirrups, wherein eachstirrup comprises a support means which supports a boot to receive thelower end of a patient's leg; said support means being attached to saidpatient support by a clamping means in such fashion that said supportmeans can be moved both vertically and horizontally; wherein said bootsare open and are provided with straps to close said boots and said bootsare provided with a removable first cushioning means which lines theinside of said boots; and said boots are provided with a removablesecond cushioning means which covers a patient's foot while in saidboots; whereby said telescoping pole can be lowered so that the topsurface of said patient support is at the level of the seat of awheelchair.
 5. An examination table comprising:a base, a telescopingpole attached to the base, and a patient support on top of saidtelescoping pole whereby said patient support can be moved upwardly ordownward; said patient support having a head end, a foot end, and twosides; attached near the foot of said patient support is a first pair ofstirrups and a second pair of stirrups, wherein each stirrup comprises asupport means which supports a boot to receive the lower end of apatient's leg; said support means being attached to said patient supportby a clamping means in such fashion that said support means can be movedboth vertically and horizontally; whereby said telescoping pole can belowered so that the top surface of said patient support is at the levelof the seat of a wheelchair.
 6. An examination table comprising:a base,a telescoping pole attached to the base, and a patient support on top ofsaid telescoping pole whereby said patient support can be moved upwardlyor downward; said patient support having a head end, a foot end, and twosides; attached near the foot of said patient support is a first pair ofstirrups, wherein each stirrup comprises a support means to receive thelower end of a patient's leg; said support means being attached to saidpatient support by a clamping means in such fashion that said supportmeans can be moved both vertically and horizontally; a second pair ofstirrups; and means to secure a patient on the examination table;whereby said telescoping pole can be lowered so that the top surface ofsaid patient support is at the level of the seat of a wheelchair.
 7. Theexamination table according to claim 6 further including at least onearm board.
 8. The examination table according to claim 6 wherein saidsupport means support a boot to receive the lower end of a patient'sleg.
 9. The examination table according to claim 6 wherein the means tosecure a patient on the examination table is a guard rail.
 10. Theexamination table according to claim 6 wherein the means to secure apatient on the examination table is at least one strap.